Tourniquets

Tourniquets have a longstanding history in combat casualty care, but only became widely accepted in the last 20 years as effective and safe. This review seeks to examine the history of tourniquets in combat casualty care and analyze their translation from military to civilian trauma care.

The most recent research focusing on prehospital tourniquet use has focused on the expansion of tourniquets to the civilian trauma patient population. Research has shown that tourniquet use can be effectively taught to civilians without medical training, and that placement of tourniquets in the prehospital environment can reduce blood loss and shock at admission. Other recent research has established the effectiveness of tourniquets in unique military environments such as in cold weather gear and when chemical, biological, radiological, and nuclear (CBRN) gear is worn.

Tourniquets have become a standard piece of equipment for deployed servicemembers for their lifesaving potential. Evidence is building that tourniquets can play a similar role in civilian trauma, but more work is needed to demonstrate the cost effectiveness and mortality benefit of widespread civilian tourniquet training and application.